Viewpoint from Beth

My name is Beth Zupec-Kania and I'm the consultant nutritionist for The Charlie Foundation.

In my 33 years of working with nutrition therapies, none comes close to the remarkable results I’ve seen achieved with ketogenic diets. I’ve had the honor of working with hundreds of people on the diet, which has taken me all over the world where together with The Charlie Foundation we have trained over 130 hospitals in ten countries.

The ketogenic diet was used in several major U.S. medical centers as an epilepsy treatment until post-World War II development of new anti-seizure medications became standard protocol. The ketogenic diet was almost extinct in 1994 when a little boy named Charlie Abrahams developed difficult-to-control epilepsy. His parents learned about the diet in a medical textbook and took him to Johns Hopkins Hospital in Baltimore, Md. His seizures stopped within days of starting the diet and he remained on it for five years. He is now 21, remains seizure-free, lives on his own and attends college.

The family shared their story with the media and answered thousands of letters that followed. Charlie’s father, Jim Abrahams, wrote, directed and produced First Do No Harm, a 1997 television movie starring Meryl Streep and based on a true story of another child who also became seizure-free thanks to a ketogenic diet. This began a surge in interest worldwide and spurred further research which has proven the effectiveness of the diet as a treatment for epilepsy.

The ketogenic diet as a treatment for epilepsy was discovered in 1921 by Dr. Russel Wilder, MD, of the Mayo Clinic. At about the same time, German biochemist and Nobel laureate Otto Warburg published a study showing that cancer cells, unlike normal cells, use glucose for energy. (Recent interest in this theory has prompted both animal and human studies showing striking results of the low-carbohydrate [low-glucose] ketogenic diet in certain cancers.)

In 1995 I worked with a teenager who had a large inoperable brain tumor that caused seizures. He was given just weeks to live but his tenacious mother pursued all possible treatments and was referred to me to start the ketogenic diet. Not only did he stop having seizures, he became more alert and active, and was able to enjoy life for another year. His neurologist determined that the diet stopped his seizures and also slowed the rapid growth of his lethal brain tumor. It was then that I realized the diet worked for more than epilepsy.

In 1999 I was asked to initiate the diet in a girl who had been in intensive care for three months. She was suffering constant seizures and had been placed in a drug-induced coma several times in efforts to arrest her seizures. Within a week of providing her a ketogenic formula through a feeding tube, her seizures diminished and she was soon able to go home. This method of ketogenic diet delivery has since been reported effective in over 40 patients in a dozen separate medical publications. A recent publication that I co-wrote includes five such cases.

The diet is traditionally offered after the failure of two or more anti-seizure medications. Statistically, after a second drug has been tried, the likelihood of another one controlling seizures is less than 3 percent. Those are poor odds, yet many of the people I’ve worked with over the years have tried multiple combinations and as many as seven different drugs.

Ketogenic diets improve epilepsy in over half of those who try it. This has been documented in multiple prospective studies including a report summarizing the results from 19 hospitals that collectively treated over 1,000 children.

If the ketogenic diet can have such a strong impact where no drug or drug combination has helped, could it help others with less intense epilepsy?

Similarly, is it possible to prevent certain types of epilepsy simply by eating differently? It would seem that a clue may be found in the type of epilepsy.

And if we evaluate those who become seizure-free on ketogenic diets, could we determine the metabolic link to their epilepsy? Could they achieve seizure control or even prevent their epilepsy by following a special diet (without going to the extreme of a high-fat, low-carbohydrate ketogenic diet)?

My educated guess is this “special diet” would be based on whole (unprocessed) foods including fats and would eliminate sweets and added sugars. The Charlie Foundation has recently published guidelines on how to follow this type of special diet.

I feel privileged to be involved in the lives of people who have tried ketogenic diet therapies. Their cooperation and diligence has fueled my efforts to educate the community and professionals to make the diet more available, easier to manage and more delicious. With research underway on the impact of ketogenic diets in many different conditions, it is my greatest hope that these special diets evolve to the level of disease prevention.

On a personal note, I myself have adopted a low-carbohydrate diet with sufficient protein and liberal fat.

People are shocked when they see me pour olive or grapeseed oil over my fish or salad. Although I don’t attempt to achieve the extremely high fat content of ketogenic diets, fat is the main source of calories in my diet.

Eating this way I’ve experienced many benefits including clearer thinking and a greater energy level. No longer do I have the afternoon “slump.” My complexion is clearer and the post-meal bloating I experienced before is gone.

When I’m asked about my diet, my simplest explanation is that I'm on ancestral diet with generous fats—this means natural and unprocessed foods including meat, fish, poultry, vegetables, berries and fats from nut and seed oils. This is what our early ancestors ate. I feel full for long periods and typically eat only two meals a day (not advised for children).

Although it can be difficult to maintain this kind of diet in our carb-loaded society, eating at home is my best option. This lifestyle has also forced me to be a better advisor to my patients and students.